Hayreh S S
Baillieres Clin Rheumatol. 1991 Dec;5(3):431-59. doi: 10.1016/s0950-3579(05)80064-0.
Giant cell arteritis (GCA) is an ophthalmic emergency because, if undetected or managed inadequately, there is a high risk of developing a painless, permanent blindness in one or both eyes; however, if it is quickly identified and treated urgently and aggressively, blindness is almost entirely preventable. The ocular manifestations of GCA are essentially ischaemic in nature, with blindness as the most dreaded complication. Blindness is usually due to anterior ischaemic optic neuropathy (AION) and occasionally to other causes, e.g. posterior ischaemic optic neuropathy or central retinal or cilioretinal artery occlusion, although extremely rarely it may be cortical in origin. Diplopia and other types of ophthalmoplegias are seen in some cases but are usually transient in nature. Ischaemic lesions of the anterior segment of the eye are also seen in a few cases. Diagnosis of arteritic AION is discussed at length. Finally, management of GCA from the point of view of visual loss is discussed in detail.
巨细胞动脉炎（GCA）是一种眼科急症，因为如果未被发现或治疗不当，一只或双眼发生无痛性永久性失明的风险很高；然而，如果能迅速识别并进行紧急且积极的治疗，失明几乎完全可以预防。GCA的眼部表现本质上是缺血性的，失明是最可怕的并发症。失明通常是由于前部缺血性视神经病变（AION），偶尔也由其他原因引起，如后部缺血性视神经病变或视网膜中央或睫状视网膜动脉阻塞，尽管极罕见情况下可能起源于皮质。有些病例会出现复视和其他类型的眼肌麻痹，但通常是短暂性的。少数情况下也可见眼前节的缺血性病变。本文将详细讨论动脉炎性AION的诊断。最后，将从视力丧失的角度详细讨论GCA的治疗。
